Citation Nr: 9820689
Decision Date: 07/07/98 Archive Date: 07/13/98
DOCKET NO. 98-00 883 ) DATE
)
)
On appeal from the
Department of Veterans Affairs Regional Office in Cheyenne,
Wyoming
THE ISSUE
Entitlement to service connection for post-traumatic stress
disorder (PTSD).
REPRESENTATION
Appellant represented by: Veterans of Foreign Wars of
the United States
ATTORNEY FOR THE BOARD
Norman R. Zamboni, Associate Counsel
INTRODUCTION
The veteran served on active duty from September 1969 to
March 1972.
This matter comes before the Board of Veterans’ Appeals
(Board) on appeal of a February 1997 decision by the
Department of Veterans Affairs (VA) Regional Office (RO)
located in Cheyenne, Wyoming, which denied the veteran's
claim for service connection for PTSD.
REMAND
Service connection for post-traumatic stress disorder
requires credible supporting evidence that an in-service
stressors actually occurred, medical evidence establishing a
clear diagnosis of the condition, and a link, established by
medical evidence, between current symptomatology and the
claimed in-service stressor.
Zarycki v. Brown, 6 Vet. App. 91 (1993).
In Zarycki, the United States Court of Veterans Appeals
(Court) stated that the presence of a recognizable stressor
is the essential prerequisite to a PTSD diagnosis. To
establish a recognizable stressor, evidence of record must
demonstrate the existence of a stressful event. Then, a
determination must be made as to whether the stressful event
is of sufficient quality to support a PTSD diagnosis. See
also West v. Brown, 7 Vet. App. 70 (1994).
According to Zarycki and West, the question of the existence
of an event claimed as a recognizable stressor must be
resolved by adjudicatory personnel. If the adjudicators
conclude that the record establishes the existence of such a
stressor, then and only then, the case should be referred for
a medical examination to determine the sufficiency of the
stressor and as to whether the remaining elements required to
support a diagnosis of PTSD have been met. In such a
referral, the adjudicators should specify to the examiner
precisely which stressor or stressors have been established
by the record, and the medical examiners must be instructed
that only those events may be considered in their diagnosis.
If the adjudicators determine that an alleged in-service
stressor is not established by the record, a medical
examination to determine whether PTSD is present would be
pointless. Likewise, if the examiner renders a diagnosis of
post-traumatic stress disorder that is not clearly based upon
in-service stressors whose existence the adjudicators have
accepted, the examination would be inadequate for rating
purposes.
The record contains the report of a November 1995 VA
psychiatric examination which reflects a diagnosis of PTSD.
The record also contains VA hospital summaries, dated in
February 1995 and October 1995, which also reflect diagnoses
of PTSD.
In a written statement, dated in July 1995, the veteran
claims he was exposed to several traumatic incidents while in
service. In one incident described by the veteran, his unit
went to a rifle qualification range in Japan. Following
qualification, the veteran and other members of his unit were
instructed to fire excess ammunition down the range in order
to “burn it off.” The veteran states the members of his
unit fired their weapons on a fully automatic setting,
“spraying” rounds of ammunition “all over.” According to
the veteran, a Japanese Officer Candidate was accidentally
shot in the legs, and subsequently had them amputated. The
veteran states he has always “felt badly” about that
incident.
The veteran also describes another incident in which he
witnessed a Chinook helicopter crash in Vietnam. According
to the veteran, he and several other soldiers ran to the
crash site and discovered the dead body of a Specialist Four.
With regard to the helicopter crash the veteran claims to
have witnessed, the veteran has provided the city of the
alleged accident, the approximate month and year of the
accident, the type of helicopter, and the probable unit to
which the helicopter belonged. Although the veteran has not
provided the name of the alleged victim, the veteran has
given the rank of the soldier ostensibly killed.
With regard to the accidental shooting which the veteran
claims he took part in, the veteran has provided the
approximate month and year of the incident, his unit of
assignment at the time, the location of the firing range, and
his duty station.
The record contains a letter, dated in July 1995, which was
prepared by the RO for submission to the U.S. Army & Joint
Services Environmental Support Group (now the U.S. Armed
Services Center for Research of Unit Records) in an effort to
substantiate the incidents claimed to be stressors by the
veteran. It appears, however, that the letter was never
sent.
The Board is of the opinion that submission of the
information provided by the veteran to the U.S. Armed
Services Center for Research of Unit Records is necessary
prior to making a determination as to the existence of the
claimed stressors.
In light of the above, this case is REMANDED for the
following actions:
1. The RO should request that the
veteran provide any additional details
regarding the stressors to which he was
allegedly exposed in service. These
details should include, if possible,
more specific dates, places, or any
other identifying information concerning
individuals involved in the events.
2. The RO should then prepare a summary
of the claimed stressors based on review
of all pertinent information. In
particular, the RO should include the
veteran's unit of assignment, his duty
station, the month and year of the
alleged incidents, and the location of
the alleged incidents. Regarding the
alleged helicopter crash, the RO should
include the type of helicopter involved
and the probable unit to which the
helicopter belonged.
3. The RO should then submit this
summary to the
U.S. Armed Services Center for Research
of Unit Records (USASCRUR), 7798 Cissna
Road, Suite 101, Springfield, Virginia,
22150-3197. The RO should specifically
request that USASCRUR search the daily
staff journals and aircraft incident
reports for the units named by the
veteran.
4. Following the above, the RO must
make a specific determination, based
upon the complete record, with respect
to whether the veteran was exposed to a
stressor in service, and if so, what was
the nature of the specific stressor. If
the RO determines that the record
establishes the existence of a stressor,
the RO must specify which stressor it
has determined is established by the
record. In reaching this determination,
the RO should specifically address any
credibility questions raised by the
record.
5. If the RO determines that the record
establishes the existence of an in-
service stressor, the RO should arrange
for the veteran to be afforded a VA
psychiatric examination for the purpose
of ascertaining the nature, extent of
severity, and etiology of any
psychiatric disorders including PTSD
which may be present. The RO must
specify for the examiner the stressor or
stressors it has determined are
established by the evidence, and the
examiner must be instructed that only
those events may be considered in
reaching a PTSD diagnosis. Any
necessary special studies or tests, to
include psychological testing with PTSD
subscales, should be accomplished. The
entire claims folder and a separate copy
of this remand must be made available to
the examiner prior to the examination.
The examination report should specify
all pertinent material reviewed in the
claims folder. If a diagnosis of PTSD
is made, the examiner should specify
whether each alleged stressor found by
the RO was sufficient to produce PTSD,
and whether the remaining diagnostic
criteria to support the diagnosis of
PTSD have been satisfied. The examiner
should also render an opinion as to
whether it is more likely than not that
any acquired psychiatric disorder found
is related to the veteran’s service or
any incident therein. The examination
report should include the complete
rationale for all opinions expressed.
6. Thereafter, the RO should review the
claims folder to ensure that all of the
above requested development has been
conducted and completed. In particular,
the RO should review the requested
examination report and required opinions
to ensure that they are responsive to
and in complete compliance with the
directives of this remand and if they
are not, the RO should implement
corrective procedures
7. After undertaking any development
deemed essential in addition to that
requested above, the RO should
readjudicate the issue of entitlement to
service connection for PTSD.
If the benefit sought on appeal is not granted to the
veteran’s satisfaction, the RO should issue a supplemental
statement of the case. The required period of time for a
response should be afforded. Thereafter, the case should be
returned to the Board for further appellate review, if
otherwise in order. By this remand, the Board intimates no
opinion as to any final outcome warranted. No action is
required of the veteran until he is notified by the RO.
This claim must be afforded expeditious treatment by the RO.
The law requires that all claims that are remanded by the
Board of Veterans’ Appeals or by the United States Court of
Veterans Appeals for additional development or other
appropriate action must be handled in an expeditious manner.
See The Veterans’ Benefits Improvements Act of 1994, Pub. L.
No. 103-446, § 302, 108 Stat. 4645, 4658 (1994), 38 U.S.C.A.
§ 5101 (West Supp. 1997) (Historical and Statutory Notes).
In addition, VBA’s ADJUDICATION PROCEDURE MANUAL, M21-1, Part
IV, directs the ROs to provide expeditious handling of all
cases that have been remanded by the Board and the Court.
See M21-1, Part IV, paras. 8.44-8.45 and 38.02-38.03.
THOMAS J. DANNAHER
Member, Board of Veterans' Appeals
Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the
Board of Veterans' Appeals is appealable to the United States
Court of Veterans Appeals. This remand is in the nature of a
preliminary order and does not constitute a decision of the
Board on the merits of your appeal. 38 C.F.R. § 20.1100(b)
(1997).
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